Retrospective case series with one year follow-up after radial nerve palsy associated with humeral fractures

Lang, Nikolaus; Ostermann, Roman C.; Arthold, Cathrin; Joestl, Julian; Platzer, Patrick

doi:10.1007/s00264-016-3186-3

Cited by 15 publications

(11 citation statements)

References 24 publications

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“…Seventeen studies provided data on humeral shaft fractures in their population [3,5,7,9,[11][12][13][14][15][16][17][18][19][20][21][22][23][24]. Five studies provided information regarding findings at exploration but did not provide background epidemiological fracture data [8,10,22,[25][26].…”

Section: Characteristics Of Studiesmentioning

confidence: 99%

Incidence and Management of Radial Nerve Palsies in Humeral Shaft Fractures: A Systematic Review

Hegeman

Polmear

Nesti

et al. 2020

Cureus

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Radial nerve palsies in closed humeral shaft fractures are common, with an incidence of 7%-17%. The management of radial nerve palsies in closed fractures is often expectant, with 70.7% spontaneously recovering within six months. A literature search was conducted for studies on radial nerve palsies in humeral shaft fractures from 2000-2018. A total of 4972 humeral shaft fractures were identified, with an incidence of 12.2% of primary radial nerve palsies. During the exploration, no neurological intervention was performed in nearly 41% of cases, and the most common finding was no evidence of any nerve lesion (35%). Those who underwent neurolysis were more likely to resolve when compared to primary repair or nerve grafting. Overall, there was a high rate of spontaneous radial nerve palsy recovery (85%) with radial nerve exploration increasing rates of resolution. While exploration demonstrates increased resolution, it is yet to be determined which fractures are indicated for nerve exploration.

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Section: Characteristics Of Studiesmentioning

confidence: 99%

Incidence and Management of Radial Nerve Palsies in Humeral Shaft Fractures: A Systematic Review

Hegeman

Polmear

Nesti

et al. 2020

Cureus

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“…However, fracture type and trauma mechanism had no significant influence on the grade of nerve damage. 10 Most researchers contend that tendon transfer in patients with radial nerve palsy may bring about good results once nerve repair has failed. When no improvement in radial nerve lesions is noticed within a one-year interval, tendon transfer may be recommended.…”

Section: Discussionmentioning

confidence: 99%

Functional Outcome by Evaluation of Dash Score on Drop Hand Patient Treated With Jones’ Tendon Transfer: A Retrospective Study

Sumarwoto

Hadinoto

Pradhana

2021

JOINTS

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Background: Drop hands due to radial nerve injuries cause functional and structural disabilities. Tendon transfer became the last option when nerve repair could not give patients restoration. The most popular method was Jones' Tendon transfer to restore wrist dorsiflexion, extending the thumb and the fingers. The Disabilities of Arm, Shoulder, and Hand (DASH) score measures functional outcomes in patients with upper extremities injuries. This study was to acknowledge the functional outcome and evaluate the DASH score in drop hand patients who undergone surgery by Jones’ Tendon Transfer in Prof. Dr. R. Soeharso Orthopaedic Hospital Surakarta from January 2014 to June 2016.Methods: The collected data from the medical record was evaluated based on functional outcome and DASH score. Eleven patients were included, ten male patients (90.9%) and one female patient (9.1%). The mean age of patients was 27.4 years old, with the most frequently injured arm was the right arm, counted to be eight patients (72.7%), and the left arm was three patients (27.3%).Results: The result from the evaluation of the DASH score indicated ten patients (90.9%) were minimal disability, and one patient (9.1%) was moderate disability. The average score was 12.48, which means that most patients could cope with most daily living activities post-operatively.Conclusions: In conclusion, surgery for drop hand due to radial nerve palsy by Jones’ Tendon Transfer gave a satisfactory functional outcome based on the DASH score.

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“…This is to avoid placing a plate directly on the nerve and because there is a reported preponderance of visible nerve lesions with open fractures, probably because these fractures are due to high-energy trauma, where tissue is more heavily damaged than with low-energy trauma (3)(4)(7)(8)(9)(10)(13)(14)18). In any case, there is a 7-32 % chance of sustaining an iatrogenic, secondary radial nerve palsy when performing open plating (2)(3)5,(10)(11)17) with possible risk variations related to the operative approach chosen (4).…”

Section: Discussionmentioning

confidence: 99%

“…Acta Orthopaedica Belgica, Vol. 87 - 3 -2021 In some studies, the incidence is a little higher with mid-shaft or mid to distal-shaft fractures, and with transverse fractures and spiral fractures compared to oblique and comminuted fractures (3)(4)(8)(9)(13)(14)17).…”

Section: Introductionmentioning

confidence: 99%

Secondary radial neuropathy after closed intramedullary nailing of humeral shaft fractures. Results over a 10-year period

Ulstrup¹

2021

Acta Orthop Belg

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Background. Retrospective study to examine secondary radial nerve palsy after humeral shaft fixation with closed locked intramedullary nailing. Materials and methods. Patients were identified from the hospitals’ registration systems for humeral shaft fractures, nerve lesions, plating, nailing and external fixation during a 10-year period from January 2007 to December 2016. All radial nerve lesions were registered and followed-up in patient files. Results. 89 patients with locked intramedullary nailing were available for an outpatient follow-up. Mean age was 67 years at the time of injury. 72 fractures were non-pathological. Of these, 31 were nonunions. 28, 61 and zero were identified in the proximal, middle and distal thirds of the humeral shaft respectively. 76 procedures were closed and 13 were with open reduction. Six radial nerves had nerve exploration. Eight patients developed immediate postoperative radial nerve palsies. Of these, six developed after closed surgery, two after nerve exploration. Of seven available patients with a radial nerve palsy, six of these remitted. Two patients were later surgically explored. One patient out of 89 sustained a verifiable permanent radial nerve paralysis. Conclusions. In this study, the risk of a radial nerve palsy was 7.9 % with closed locked intramedullary nailing. This study suggests that exploration of the radial nerve is not necessary routinely in order to prevent radial nerve lesions when performing closed intramedullary nailing for humeral shaft fractures in adults with a preoperative normal radial nerve function. Level of Evidence : Level IV.

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Retrospective case series with one year follow-up after radial nerve palsy associated with humeral fractures

Cited by 15 publications

References 24 publications

Incidence and Management of Radial Nerve Palsies in Humeral Shaft Fractures: A Systematic Review

Incidence and Management of Radial Nerve Palsies in Humeral Shaft Fractures: A Systematic Review

Functional Outcome by Evaluation of Dash Score on Drop Hand Patient Treated With Jones’ Tendon Transfer: A Retrospective Study

Secondary radial neuropathy after closed intramedullary nailing of humeral shaft fractures. Results over a 10-year period

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